HomeMy WebLinkAboutX2008-2571 - PermitsCity of Newport Beach
Building Department
PO Box 1768 Newport Beach, California 92658-8915
Permit Counter Telephone (949)644-3288
Combination Type - BLDG/ ELEC/ / /
COMB Permit No: X2008-2571
Inspection Requests/Telephone (949)644-3255
Job Address: 1 HOAG DR NB
Inspector Area: 7
OF LOT
Owner:
Address:
Phone:
Applicant:
Address:
Phone:
HOAG HOSPITAL FD&C
500 SUPERIOR AVE STE 300
NEW PORT BEACH CA 92663
949-764.4486
DURAN MIGUEL
10280 GLENOAKS BLVD
PACOIMA CA 91331
818-899-1888
Code Edit :
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No of Units:
Bldg Height:
Bldg Sprinklers:
Flood Zone:
Issued Date: 01/23/2008
Description: INSTL (2) ILLUM DIRECTIONAL SIGNS
Project : 2261-2008 2261-2008
Legal Desc.: IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR
Contractor:
Address:
Phone:
Con State Lic:
Lic Expire:
Bus Lic:
Lic Exp Date:
CA SIGNS
10280 GLENOAKS BLVD
PACOIMA CA 91331
818-899-1888
413813
10/31/2009
BT30020072
07/31/2009
2007 Worker's Compensation Insurance
VB Carrier:
Policy No:
Expire:
U
0
0
0
0
0
N
EVEREST NAITIONAL
CA20010627081
11/01/2009
Building Setbacks Rear: /
Front: /
Left: 1
Right: /
Construction Valuation: $30.000.00
Building Permit Fee: $460.00
Plan Check Fee: $331.20
Overtime Plan Ck: $0.00
Investigatin Fee: $0.00
Record Management : $38.00
Energy Compliance: $50.00
CA Seismic Safety : $0.00
Disabled Access • $0.00
Fee Increase: Fee: $0.00
Additional Fee : $0.00
Hazardous Mat : $0.00
Building Green Fee : $2.00
TOTAL FEE:
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Use Zone:
Parking Spaces: 0
San Dist :
Excise Tax:
NMUSD Fee:
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee :
Electrical %:
Mechanical 910:
Plumbing %:
$1,396.69
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$40.25
$0.00
$0.00
FEES
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
State Lic:
JOHNSON CHARLES AJR
P.O. BOX 6284
GARDEN GROVE CA92846
714-227-0373 State Lic:S-002537
CA SIGNS
10280 GLENOAKS BLVD
PACOIMA CA 91331
818-899-1888
Special Conditions:
Fire Hazard Zone : N
Planning Department -
Plan check Fee : $119.00
Fair Share : $0.00
SJH Trans : $0.00
Public Works Department -
Park Dedication : $0.00
P/VJ Plan Check : $60.00
Plan Check:, :.•. $33.945
• • ; • ••
•
••• •.
•
• •
PLAN CHECK BY:
••• •
•
• • : • API4QV$2TO•I6SUE:
PERMITS EXPIRE 180 DAYS AFTCR /SRUAN€P' QR:AFT VA-0 INSPECTION.
••• •• • • • • ••• �••
Fire Department
Fire Inspection:
Fire Plan Rev
Demolition Fee
Building Dept Adm
General Service
Refund Deposit
Fee Due at Permit Issuance :
• ••PUBGG WO•RItS APPROVAL:aLSti
/
$230.00
$66.24
$0.00
$0.00
$0.00
$0.00
$0.00
$1,057.44
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s)
indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions
Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its
issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the
provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (, all of or portions of the
work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property whet through employees' or personal effort, builds or improves the
d
property, e provided of that the
improvements
willdha er thee burdenfor s of role. ving however,the
was not built or Improvedtis forsthe
purpose of sale). Pproving
U I, as owner of the property am exclusively contracting with licensed Contractors to construct the project (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or
impwroves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors State License
❑ I am exempt from licensure under the Contractors' State License Law for the following reason.
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year
prior to completion of the improvements covered by this permit, I cannot legally sell a structure that I have built as an owner -
builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law,
Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the
following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000)
of Division 3 of the Business and Professions Code, and my license is in full force and effect.
Licepse Class Li o.
L'^ 7-6 — CodtrardbeSignature
ORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO
CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of
In 'al Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Is
o.
aye and will maintain workers' compensation insurance, as required_ by Section 3700 of the Labor Code, for the
rforrnance of the work for which this permit is issued. My workers' compensation Insurance carder and policy number are:
Carrier Policy Number Expiration Date
Name of Agent Phone #
❑ I certify that, in the performance of the work for which this permit Is issued, I shall not era loy any person in any manner
so as to become subject to, the workers' compCensation laws of Califomia and agree that if ould become subject to the
workers' compensation Provisi• •. ection 300 of the Labor Code I shad forthwith oomph) 1 with hose provisions.
.�
Signature of Applicant
DECLARATRDING CONSTRUC 0 : AGENCY
I hereby affirmunder penalty of perjury that there is a construction lending agency for the performance of the work for
is
sued this permit is (Section 3097, Civil Code).
Lender's Name
Lender's Address
By my signature below, I certify to each of the following: • •.• •?• ••
••
I am the property owner or authorized to act on the property ownerlete¢SI);, • • ; •
I have read this application and the Information I have provided i , neat. • • . • • • • • •
I agree to comply with all applicable city and county ordinances and Matt Itvs relating lbj%ilding eonstrtction.
I authorize representatives of this city or county to enter the abov -iggnh led propt?nyfor inspection purposes.
Signature of Property Owner or Authorized Agent
Print Property Owner's or Authorized Agent's Name:
Date•
•• •••• ••. ••• ••
• • - • • •• • •
ACTION
PERMIT EXPIRED
DATE:
BY:
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403.
❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
FOR OFFICE USE ONLY
•
01/01/2009